Perceptions of Gown and Glove Use to Prevent Methicillin-resistant Staphylococcus aureus Transmission in Nursing Homes

Objectives

To explore current use and perceptions of glove and gown use in nursing homes.

Design

Qualitative study using focus groups and semi-structured interviews.

Setting

Three community-based nursing homes in Maryland.

Participants

Direct care staff, administrators, and residents.

Methods

We conducted three focus groups among nursing home staff, one focus group among nursing home administrators, and five interviews with residents. Topic guides were created based on our recent study results and a review of the literature. Two investigators separately analyzed the transcribed recordings and identified recurrent themes.

Results

Direct care staff reported using gowns and gloves primarily as self-protection against contact with bodily fluids, not to prevent MRSA transmission. Glove use was described as common and more acceptable to staff and residents than gown use. Administrators were surprised that MRSA transmission to health care worker hands and clothing occurred during activities when direct care staff perceives no contact with bodily fluids. Staff and administrators expressed willingness to use gowns and gloves for high-risk care activities, particularly if use is targeted toward specific types of residents such as those with pressure ulcers. There was a knowledge deficit about MRSA transmission and infection among direct care staff and residents.

Conclusions

Results from this study will inform a strategy to reduce MRSA transmission in long-term care.